Wrinkle Treatment: Q&A

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Treatment for Tear Troughs and Thin Undereye Skin?

I went to a doctor out of town for correction of my tear troughs, he told me that since I had such thin skin underneath my eyes, Restylane might not work well, and find somewhere closer to home in case of complications. Now I'm wondering if a filler or fat grafting would never be able to fix it, and if I have to live the rest of my life looking tired and older than my actual age? Also I've heard of laser treatment that thickens the skin underneath the eye. Is that really safe, and if so, what is it actually called?

18 Doctor Answers | Asked by Flagirl2257 in Florida
+4

Tear trough hollowness, a tough problem.

The tear trough is a very tricky area. The skin is quite thin and almost anything you do other than hyaluronic acid fillers has a good chance of producing lumpiness. For around the eye area, we prefer Prevelle, a hyaluronic acid filler that lasts about 3 months. I have never seen swelling of any signifance from this filler. Restylane is also fine for patients who aren't too sensitive. Patients should always allow a little recovery time after Restylane. Juvederm around the eyes tends to... more
+3

Tear troughs and thin eyelid skin

Restylane for correction of the tear trough area when injected in the correct location can still work well in people with thin eyelid skin. Loose/thin eyelid skin can be tightened and somewhat thickened with fractional laser (CO2 or Erbium) or chemical resurfacing. Depending on your skin type, to avoid lines of color demarcation, full face resurfacing might be appropriate. I would seek consultation with a physician who will take the time to walk you through the potential complications in... more
+3

Treatment of the Tear Trough

Not necessarily. Tear trough can be fixed with fillers that are placed deep to the muscle over the bone, so it is not a matter of how thin the skin is. Also a more permanent procedure may be to have a lower eyelid surgery but to have the fat transposed to the tear trough to smoothen the transition from the eyelid bags and the tear trough.

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+3

Fillers may work well in this area

The tear trough area can be challenging to deal with. One minimally invasive way to address this area is by using soft tissue fillers (Restylane, Juvederm). This procedure has been gaining in popularity however, should be done by someone who is experienced injecting in this area. My recommendation would be to consult with a board certified plastic surgeon to see if you are a candidate.
+2

Treatment of the tear trough

Tear troughs are often treated by doctors injecting underneath the muscle so that the thin skin is not an issue. There are risks with any procedure and it would be a good idea to have it done closer to home in case you need to see your physician afterwards. Laser treatments can help build up the collagen. Fraxel RE:store and Portrait plasma are good collagen regenerators. Fraxel RE:pair and Carbon Dioxide lasers require more healing time and carry greater risk of complications. Despite... more
+2

Laser resurfacing can thicken skin, fillers work, and fat injections may be the key

The tear trough is a tough area. This area is located between the nose and the lower eyelid and is situated not above the bone as most people believe but above the soft tissue of the eye socket and eyelid. People have tried repositioning of the eye socket fat into that area. This can work but has been shown to lead to eye position abnormalities and problems with dry eyes, etc. Fat grafting can work in this area and may be the most natural way to rejuvenate this area. It does have some... more
+2

A combination of Restylane and a laser often work well

The tear troughs are a common problem area and there are multiple options for improvement. My personal preference is to use Restylane to fill the trough, followed by either a laser or chemical peel to smooth and tighten the skin. Together, this produces a very reproducible and safe result in most patients. I would recommend talking to several surgeons with experience with this technique about your options before selecting the one to perform your procedure.
+2

Lower lid treatment

In order to get good results in the tear trough region, you have to find a qualified doctor who treats this area frequently so that it can be done correctly.  
+2

It is a shame that you have to be in a position of directing your own treatment

Dear Flagirl My father always told me "if the butcher tells you the meat's bad, you should listen." Too often when a doctor says that something can't be done, it means they have not figured out how to do it themselves. It does not necessarily mean that it can't be done. Before you give up on the best treatment option for the lower eyelid hollows, I suggest that you get some other opinions. In particular, you might look specifically for a cosmetic dermatologist who does the lower... more
+1

Fillers, especially fat, work well under eyes

I would recommend fat injection to improve the tear troughs and lower lid-cheek area. This is a procedure that requires experience. Make sure you find someone who does this regularly and look at his results. If done properly, this is a wonderful procedure with beautiful results and is minimally invasive. Alternatively, fillers such as Restylane and Juvederm can be used but will need to be repeated more frequently.
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.

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